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Amputation
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==Prevention== Methods in preventing amputation, [[limb-sparing techniques]], depend on the problems that might cause amputations to be necessary. Chronic infections, often caused by diabetes or [[decubitus ulcers]] in bedridden patients, are common causes of infections that lead to gangrene, which, when widespread, necessitates amputation.<ref>{{Cite web |date=2019-11-19 |title=Gangrene |url=https://www.hopkinsmedicine.org/health/conditions-and-diseases/gangrene |access-date=2023-10-31 |website=www.hopkinsmedicine.org |language=en}}</ref> There are two key challenges: first, many patients have impaired circulation in their extremities, and second, they have difficulty curing infections in limbs with poor blood circulation.<ref>{{Cite web |last=CDC |date=2023-04-07 |title=Preventing Diabetes-Related Amputations (Part 1) |url=https://www.cdc.gov/diabetes/library/features/amputations.html |access-date=2023-10-31 |website=Centers for Disease Control and Prevention |language=en-us}}</ref><ref>{{Cite web |title=Avoiding Amputations |url=https://www.templehealth.org/services/heart-vascular/patient-care/patient-support/understanding-heart-vascular-disease/avoiding-amputations |access-date=2023-10-31 |website=Temple Health |language=en}}</ref> Crush injuries where there is extensive tissue damage and poor circulation also benefit from [[Hyperbaric medicine|hyperbaric oxygen therapy]] (HBOT). The high level of oxygenation and revascularization speed up recovery times and prevent infections.<ref>{{Cite web |title=Hyperbaric oxygen therapy - Mayo Clinic |url=https://www.mayoclinic.org/tests-procedures/hyperbaric-oxygen-therapy/about/pac-20394380 |access-date=2023-10-31 |website=www.mayoclinic.org |language=en}}</ref> A study found that the patented method called Circulator Boot achieved significant results in prevention of amputation in patients with diabetes and arteriosclerosis.<ref name=dillon1>{{cite journal | vauthors = Bouskela E, Donyo KA | title = Effects of oral administration of purified micronized flavonoid fraction on increased microvascular permeability induced by various agents and on ischemia/reperfusion in the hamster cheek pouch | journal = Angiology | volume = 48 | issue = 5 | pages = 391β9 | date = May 1997 | pmid = 9158383 | doi = 10.1177/000331979704800503 | s2cid = 28978927 | url = http://www.circulatorboot.com/literature/angiology1.html | archive-url = https://web.archive.org/web/20101125035502/http://circulatorboot.com/literature/angiology1.html | url-status = dead | archive-date = 2010-11-25 | access-date = 2010-06-24 | url-access = subscription }}</ref><ref name=dillon2>{{cite journal | vauthors = Dillon RS | title = Patient assessment and examples of a method of treatment. Use of the circulator boot in peripheral vascular disease | journal = Angiology | volume = 48 | issue = 5 Pt 2 | pages = S35β58 | date = May 1997 | pmid = 9158380 | doi = 10.1177/000331979704800504 | s2cid = 23512929 | url = http://www.circulatorboot.com/literature/angiology1.html | archive-url = https://web.archive.org/web/20101125035502/http://circulatorboot.com/literature/angiology1.html | url-status = dead | archive-date = 2010-11-25 | access-date = 2010-06-24 | url-access = subscription }}</ref> Another study found it also effective for healing limb ulcers caused by peripheral vascular disease.<ref name=vella>{{cite journal | vauthors = Vella A, Carlson LA, Blier B, Felty C, Kuiper JD, Rooke TW | title = Circulator boot therapy alters the natural history of ischemic limb ulceration | journal = Vascular Medicine | volume = 5 | issue = 1 | pages = 21β5 | year = 2000 | pmid = 10737152 | doi = 10.1177/1358836X0000500104 }}</ref> The boot checks the heart rhythm and compresses the limb between heartbeats; the compression helps cure the wounds in the walls of veins and arteries, and helps to push the blood back to the heart.<ref>{{Cite AV media |url=https://newsnetwork.mayoclinic.org/discussion/circulator-boot/ |title=Circulator Boot |date=2008-07-11 |last=Williams |first=Vivien |type=video |publisher=[[Mayo Clinic|Mayo Clinic News Network]] |time=1:08β1:32 |access-date=2021-06-27}}</ref> For victims of trauma, advances in [[microsurgery]] in the 1970s have made replantation of severed body parts possible. The establishment of laws, rules, and guidelines, and the employment of modern equipment help protect people from traumatic amputations.<ref>{{Cite journal |last1=Roon |first1=Anthony J. |last2=Moore |first2=Wesley S. |last3=Goldstone |first3=Jerry |date=1977 |title=Below-knee amputation: A modern approach |journal=The American Journal of Surgery |volume=134 |issue=1 |pages=153β158 |doi=10.1016/0002-9610(77)90299-9 |pmid=879408 |issn=0002-9610}}</ref>
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